Organization · Type 2 NPI

Intercare Community Health Network Dental Van

Federally Qualified Health Center (FQHC) · Bangor, MI

NPI number 1194133744 Active

Practice location

308 Charles Street
Bangor, MI 49013-1246

Call (269) 427-7937 Map

Fax (269) 427-5180

Mailing address

50 Industrial Park Rd
Bangor, MI 49013-1246

Specialties and licenses

TaxonomyCodeLicense
Federally Qualified Health Center (FQHC) Primary 261QF0400XNone listed

Federally Qualified Health Center (FQHC): Definition to come...

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About NPI 1194133744

Intercare Community Health Network Dental Van's National Provider Identifier is 1194133744, issued on Jul 28, 2014. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Bangor, MI. The record was last updated on Jul 28, 2014.